Net DALYs averted at full and actual implementation levels
Intervention | (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) | (10) | (11) | (12) |
ICER ranking | ICER ($) | Pop. DALYs averted per 1000 | Cases per annum (1000 s) | Actual imp. level | Total cost (full imp.; $1000s) | Total cost (actual imp.; $1000s) | Total DALYs averted (full imp.; 1000s) | Total DALYs averted (actual imp.; 1000s) | Net DALYs averted (full imp.; 1000s) | Net DALYs averted actual imp.; 1000s) | Financial value to the healthcare system of moving from actual to full imp. ($1000s) | |
Male circumcision | 38 | 22 | 45 | 4073 | 12% | 146 730 | 17 608 | 39 634 | 4756 | 25 423 | 3051 | 1 372 314 |
Isoniazid preventive therapy for HIV+ no (TB) | 4 | 1 | 887 | 55 | 50% | 80 | 40 | 1118 | 559 | 1098 | 549 | 33 673 |
First-line treatment for new TB cases for adults | 5 | 3 | 393 | 14 | 64% | 178 | 114 | 1045 | 669 | 1002 | 641 | 22 122 |
First-line treatment for new TB cases for children | 7 | 3 | 393 | 12 | 64% | 117 | 75 | 888 | 568 | 851 | 545 | 18 789 |
Clean practices and immediate essential newborn care (home) | 9 | 3 | 368 | 671 | 0% | 416 | – | 237 | – | 227 | – | 13 909 |
Management of pre-eclampsia (magnesium sulfate) | 23 | 6 | 168 | 20 | 80% | 45 | 36 | 535 | 428 | 483 | 386 | 5923 |
Voluntary counselling and testing | 41 | 25 | 40 | 8031 | 15% | 36 309 | 5446 | 167 | 25 | 98 | 15 | 5120 |
Rotavirus vaccine | 22 | 6 | 177 | 651 | 0% | 3097 | – | 88 | – | 80 | – | 4920 |
Households owning at least one ITN/LLIN | 33 | 13 | 77 | 6752 | 56% | 13 737 | 7706 | 228 | 128 | 180 | 101 | 4847 |
Malaria treatment: first trimester—uncomplicated | 19 | 5 | 198 | 305 | 33% | 1025 | 341 | 109 | 36 | 100 | 33 | 4087 |
PMTCT | 27 | 11 | 94 | 53 | 55% | 600 | 332 | 157 | 87 | 130 | 72 | 3561 |
Malaria treatment: uncomplicated—second line (adult, >36 kg) | 13 | 4 | 260 | 4372 | 2% | 1186 | 18 | 59 | 1 | 56 | 1 | 3354 |
Malaria treatment: uncomplicated—second line (adult, <36 kg) | 14 | 4 | 260 | 4372 | 4% | 593 | 21 | 59 | 2 | 56 | 2 | 3285 |
Labour and delivery management | 28 | 11 | 89 | 918 | 65% | 1281 | 833 | 170 | 111 | 139 | 91 | 2992 |
First-line treatment for retreatment TB cases for adults | 6 | 3 | 393 | 2 | 65% | 100 | 65 | 131 | 85 | 125 | 81 | 2688 |
Mass media | 2 | 1 | 903 | 16 879 | 71% | 7609 | 5402 | 150 | 107 | 148 | 105 | 2627 |
Malaria treatment: uncomplicated (adult, <36 kg) | 11 | 4 | 260 | 4372 | 30% | 3463 | 1039 | 59 | 18 | 56 | 17 | 2383 |
Interventions focused on men who have sex with men | 48 | 51 | 20 | 34 | 5% | 1256 | 63 | 232 | 12 | 40 | 2 | 2311 |
Antenatal care (four visits) | 36 | 15 | 68 | 918 | 46% | 11 230 | 5110 | 90 | 41 | 68 | 31 | 2289 |
First-line treatment for retreatment TB cases for children | 8 | 3 | 393 | 2 | 65% | 66 | 43 | 111 | 72 | 106 | 69 | 2283 |
Malaria treatment: second trimester—uncomplicated | 20 | 5 | 198 | 305 | 67% | 235 | 157 | 109 | 72 | 100 | 67 | 2047 |
Antenatal corticosteroids for preterm labour | 40 | 25 | 40 | 165 | 0% | 406 | – | 47 | – | 28 | – | 1718 |
Newborn sepsis— full supportive care | 39 | 24 | 42 | 81 | 40% | 417 | 167 | 60 | 24 | 37 | 15 | 1346 |
Cotrimoxazole for children | 1 | cost saving | 127 | 13% | 220 | 28 | 0 | 0 | 23 | 3 | 1208 | |
Interventions focused on female sex workers | 47 | 51 | 20 | 23 | 30% | 655 | 197 | 161 | 48 | 28 | 8 | 1184 |
Vaginal delivery, skilled attendance | 31 | 12 | 83 | 918 | 65% | 5181 | 3368 | 67 | 43 | 54 | 35 | 1153 |
Malaria treatment: uncomplicated (adult, >36 kg) | 12 | 4 | 260 | 4372 | 70% | 4267 | 2987 | 59 | 41 | 56 | 39 | 1021 |
Tetanus toxoid (pregnant women) | 24 | 7 | 149 | 918 | 84% | 115 | 96 | 104 | 87 | 92 | 77 | 905 |
Malaria treatment: uncomplicated—second line (children, <15 kg) | 17 | 4 | 260 | 1042 | 2% | 35 | 1 | 14 | 0 | 13 | 0 | 799 |
Malaria treatment: uncomplicated—second line (children,>15 kg) | 18 | 4 | 260 | 1042 | 4% | 71 | 2 | 14 | 0 | 13 | 0 | 783 |
Schistosomiasis mass drug administration | 42 | 29 | 35 | 389 | 13% | 77 | 10 | 24 | 3 | 13 | 2 | 670 |
Vitamin A supplementation in pregnant women | 25 | 7 | 140 | 124 | 65% | 125 | 81 | 33 | 22 | 30 | 19 | 634 |
Malaria treatment: uncomplicated (children, >15 kg) | 16 | 4 | 260 | 1042 | 40% | 4768 | 1907 | 14 | 6 | 13 | 5 | 487 |
Antibiotics for pPRoM | 45 | 40 | 25 | 64 | 30% | 39 | 12 | 30 | 9 | 10 | 3 | 450 |
Maternal sepsis case management | 44 | 39 | 26 | 64 | 0% | 2731 | – | 20 | – | 7 | – | 449 |
Management of severe malnutrition (children) | 46 | 50 | 20 | 51 | 80% | 2437 | 1949 | 199 | 159 | 36 | 29 | 446 |
Isoniazid preventive therapy for children in contact with patients with TB | 3 | 1 | 900 | 2 | 85% | 7 | 6 | 45 | 38 | 44 | 38 | 408 |
Malaria treatment: uncomplicated (children, <15 kg) | 15 | 4 | 260 | 1042 | 60% | 4576 | 2746 | 14 | 8 | 13 | 8 | 325 |
Vaginal delivery, with complication | 32 | 12 | 83 | 138 | 51% | 804 | 410 | 10 | 5 | 8 | 4 | 242 |
Measles vaccine | 26 | 9 | 106 | 651 | 99% | 528 | 523 | 107 | 106 | 90 | 89 | 55 |
Management of obstructed labour | 30 | 12 | 86 | 92 | 100% | 1100 | 1100 | 2497 | 2497 | 2026 | 2026 | – |
Caesarean section | 43 | 32 | 31 | 34 | 100% | 672 | 672 | 327 | 327 | 157 | 157 | – |
Caesarean section (with complication) | 29 | 12 | 86 | 5 | 100% | 172 | 172 | 137 | 137 | 111 | 111 | – |
Pregnant women sleeping under an ITN | 34 | 13 | 77 | 1469 | 100% | 2990 | 2990 | 50 | 50 | 39 | 39 | – |
Under five children who slept under ITN/LLIN | 35 | 13 | 77 | 494 | 100% | 1006 | 1006 | 17 | 17 | 13 | 13 | – |
Blood safety | 37 | 15 | 66 | 40 | 100% | 1626 | 1626 | 12 | 12 | 9 | 9 | – |
Malaria treatment: pregnant women— complicated | 21 | 5 | 198 | 16 | 100% | 140 | 140 | 6 | 6 | 5 | 5 | – |
Case management of MDR TB cases | 10 | 3 | 297 | 0 | 100% | 12 | 12 | 5 | 5 | 5 | 5 | – |
Malaria treatment: pregnant women—complicated | 21 | 5 | 198 | 16 | 100% | 140 | 140 | 6 | 6 | 5 | 5 | – |
Caesarean section (with complication) | 29 | 12 | 86 | 5 | 100% | 172 | 172 | 137 | 137 | 111 | 111 | – |
Management of obstructed labour | 30 | 12 | 86 | 92 | 100% | 1100 | 1100 | 2497 | 2497 | 2026 | 2026 | – |
Pregnant women sleeping under an ITN | 34 | 13 | 77 | 1469 | 100% | 2990 | 2990 | 50 | 50 | 39 | 39 | – |
Under five children who slept under ITN/LLIN | 35 | 13 | 77 | 494 | 100% | 1006 | 1006 | 17 | 17 | 13 | 13 | – |
Blood safety | 37 | 15 | 66 | 40 | 100% | 1626 | 1626 | 12 | 12 | 9 | 9 | – |
Caesarean section | 43 | 32 | 31 | 34 | 100% | 672 | 672 | 327 | 327 | 157 | 157 | – |
IPT (pregnant women) | 52 | 110 | 9 | 735 | 100% | 35 | 35 | 0 | 0 | −0 | −0 | – |
GIT cancer | 63 | 804 | 1 | 0 | 50% | 3 | 1 | 0 | 0 | −0 | −0 | −0 |
Cervical cancer (first line) | 65 | 1087 | 1 | 2 | 50% | 162 | 81 | 0 | 0 | −0 | −0 | −0 |
Ischaemic heart disease | 61 | 453 | 2 | 128 | 15% | 4 | 1 | 0 | 0 | −0 | −0 | −2 |
Diabetes, type I | 57 | 296 | 3 | 23 | 15% | 4304 | 646 | 0 | 0 | −0 | −0 | −5 |
High cholesterol | 49 | 68 | 15 | 223 | 1% | 6703 | 67 | 1 | 0 | −0 | −0 | −6 |
Basic psychosocial support, advice and follow-up, plus antiepileptic medication | 50 | 82 | 12 | 506 | 3% | 1266 | 38 | 1 | 0 | −0 | −0 | −14 |
Treatment of depression | 56 | 265 | 4 | 169 | 1% | 332 | 3 | 0 | 0 | −0 | −0 | −23 |
Diabetes, Type II | 58 | 296 | 3 | 138 | 15% | 4211 | 632 | 0 | 0 | −1 | −0 | −30 |
Treatment of acute psychotic disorders | 66 | 1646 | 1 | 169 | 1% | 958 | 10 | 0 | 0 | −1 | −0 | −42 |
Treatment of bipolar disorder | 62 | 557 | 2 | 523 | 3% | 10 362 | 321 | 0 | 0 | −1 | −0 | −87 |
Treatment of schizophrenia | 67 | 1646 | 1 | 2363 | 14% | 13 413 | 1878 | 0 | 0 | −10 | −1 | −512 |
Hypertension | 55 | 159 | 6 | 846 | 10% | 1338 | 134 | 44 | 4 | −71 | −7 | −3912 |
ORS | 54 | 153 | 7 | 8662 | 69% | 937 | 647 | 147 | 102 | −221 | −152 | −4197 |
Zinc (diarrhoea treatment) | 51 | 99 | 10 | 7455 | 0% | 1788 | – | 244 | – | −150 | – | −9207 |
Condoms | 53 | 127 | 8 | 8031 | 47% | 22 883 | 10 755 | 482 | 226 | −517 | −243 | −16 813 |
ART for men | 59 | 312 | 3 | 332 | 75% | 21 159 | 15 961 | 1005 | 758 | −4104 | −3,096 | −61 848 |
ART for women | 60 | 312 | 3 | 509 | 82% | 32 440 | 26 669 | 1541 | 1267 | −6292 | −5,173 | −68 665 |
Paediatric ART | 64 | 892 | 1 | 107 | 25% | 7657 | 1892 | 1556 | 384 | −21 074 | −5,206 | −973 334 |
ART, antiretroviral therapy; DALY, disability adjusted life year; GIT, gastrointestinal; ICER, incremental cost effectiveness ratio; IPT, intermittent preventive therapy; ITN, insecticide-treated bed net; LLIN, long-lasting insecticidal net; MDR, multidrug resistant; ORS, oral rehydration salts; PMTCT, prevention of mother to child transmission; pPRoM, preterm premature rupture of membranes; TB, tuberculosis.